Bullous Erythema Multiforme or Rowell Syndrome: A Case Report

Bullous erythema multiforme is characterized by the presence of target lesions with a bullous center, distributed bilaterally and relatively symmetrically on the extremities. Rowell's syndrome is a type of subacute cutaneous lupus erythematous that mimics erythema multiforme. These two diagnoses have a similar histopathology with interface dermatitis. To differentiate these two entities, we use the criteria of Rowell et al., Lee et al., Zeitouni et al., or Torchia et al., According to these criteria, the diagnosis of Rowell syndrome requires the presence of lupus lesions and antinuclear antibodies. In our case, the pathologist mistook erythema multiforme for subacute cutaneous lupus because of the presence of interface dermatitis. However, our patient did not meet any of the criteria for the diagnosis of Rowell's syndrome. The patient was treated as having erythema multiforme with a good outcome.